A.—4b.

Samoan Medical Department. It is necessary to refer to the work of the Samoan Medical Department. In the opening speech of counsel for the complainants allegations were made reflecting on the efficiency of the Medical Department of the Administration—which included the care of sanitation and general public health—and on its cost. These charges were at the conclusion of the evidence withdrawn. We nevertheless think it right to make a few observations on the subject. In our opinion, the medical administration has been most zealously conducted by its Medical Officers, and has been most efficient. The greatest desire has been evinced to spread the benefits of medical attention over as wide an area as possible. The efficiency of the Medical Department in Samoa can readily be demonstrated. From 1886 to 1917 —a period of thirty-one years —the increase of the Native population was very slow, requiring a period of approximately ninety-two years to double itself. In 1918 an epidemic of influenza caused a loss of the whole increase of population during the preceding twenty-one years. Since that date the rate of increase of population has been greater, and during the last three years it has been greater than at any other period. The loss during the epidemic, which was equal to the gain in population during the twenty-one years (approximately) preceding it, has been more than made up in eight years. Dr. S. M. Lambert, of the International Health Board of the Rockefeller Foundation, in his report on Western Samoa, 1924 (page 37 A.-4a) says, — In Samoa we have a long-visioned Administration which is giving every support to a strong Native Department and a modern Department of Public Health, these two working hand-in-hand. Yaws is well under control, and may be eradicated in the near future. Hookworm-control measures are well advanced, and will now be prosecuted with the vigour given to the yaws campaign. Adequate sanitation, proper latrines, and pure water supply are gradually being installed in all villages. Definite plans are undertaken for child-welfare work in Native villages with the new year. The same authority, in his " Health Survey of the New Hebrides," 1926, on page 15, says, —- The vital question as to whether the decline of Native Pacific races can be checked and their numbers brought back has been answered brilliantly by the New-Zealanders in Samoa by intensive efforts against hookworm disease and yaws, especially with good hospitalization and the establishment of confidence in their Government in the Samoan mind. In a period of less than three years a birth and death rate practically equal has been changed to a birth-rate of 55 and a death-rate of 22, with an infant-mortality rate that many civilized countries might envy. Samoa lays emphasis on her yaws and hookworm campaigns as the important features of this racial recovery. P. A. Buxton, M.R.C.S., D.T.M., and H., formerly Milner Research Fellow, and now Director of Medical Entomology, London School of Hygiene and Tropical Medicine, in his " Researches in Polynesia and Melanesia," published in London in July, 1927, at page 4 remarks of Samoa, — It is, perhaps, not impertinent to state that New Zealand provides a public-health service which might serve as a model to any small tropical country, and that the administration of that Department seemed to be characterized by vision and forethought. Dr. Ritchie, who before being appointed Chief Medical Officer in 1922 had been associated with the medical service in Western Samoa, and his efficient medical colleagues, are entitled to full credit for the remarkable improvement effected in the health of the people. We are glad to be able to make these observations, because a very uninformed attack was made upon Dr. Ritchie by some of the witnesses. He was, unfortunately, taken seriously ill after the opening of the Commission, and could not be called as a witness on the medical subjects involved in the inquiry. We are satisfied that careful attention has been paid to public health and sanitation, and it is only necessary to refer to Dr. Hunt's evidence on this subject. We will, for convenience' sake, refer in the second part of this report to the medical tax which was complained of before us. Mr. Williams's report, which was read at the public meeting to which we have so often referred, affords a striking example of a very misleading statement made in connection with hospital administration. Referring to the nursing staff at the Apia Hospital, he said (see page 14 of A.-4b), " In 1925-26 the number of in-patients admitted to hospital was 144, which works out at an average of sixteen patients to each nurse per year—which is certainly

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